Crowdsourcing to promote HIV testing among MSM in China: Study protocol for a stepped wedge randomized controlled trial

SESH Study Group

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    Background: HIV testing for marginalized populations is critical to controlling the HIV epidemic. However, the HIV testing rate among men who have sex with men (MSM) in China remains low. Crowdsourcing, the process of shifting individual tasks to a group, has been increasingly adopted in public health programs and may be a useful tool for spurring innovation in HIV testing campaigns. We designed a multi-site study to develop a crowdsourced HIV test promotion campaign and evaluate its effectiveness against conventional campaigns among MSM in China. Methods: This study will use an adaptation of the stepped wedge, randomized controlled trial design. A total of eight major metropolitan cities in China will be randomized to sequentially initiate interventions at 3-month intervals. The intervention uses crowdsourcing at multiple steps to sustain crowd contribution. Approximately 1280 MSM, who are 16 years of age or over, live in the intervention city, have not been tested for HIV in the past 3 mmonths, and are not living with HIV, will be recruited. Recruitment will take place through banner advertisements on a large gay dating app along with other social media platforms. Participants will complete one follow-up survey every 3 months for 12 months to evaluate their HIV testing uptake in the past 3 months and secondary outcomes including syphilis testing, sex without condoms, community engagement, testing stigma, and other related outcomes. Discussion: MSM HIV testing rates remain poor in China. Innovative methods to promote HIV testing are urgently needed. With a large-scale, stepped wedge, randomized controlled trial our study can improve understanding of crowdsourcing's long-term effectiveness in public health campaigns, expand HIV testing coverage among a key population, and inform intervention design in related public health fields. Trial Registration:, NCT02796963. Registered on 23 May 2016.

    Original languageEnglish
    Article number447
    Issue number1
    Publication statusPublished - 2 Oct 2017

    Bibliographical note

    Funding Information:
    This work is supported by National Institutes of Health (National Institute of Allergy and Infectious Diseases 1R01AI114310-01), UNC-South China STD Research Training Center (Fogarty International Center 1D43TW009532-01), UNC Center for AIDS Research (National Institute of Allergy and Infectious Diseases 5P30AI050410), University of California San Francisco Center for AIDS Research (National Institute of Allergy and Infectious Diseases P30 AI027763), National Institute of Mental Health (R00MH093201), UJMT Fogarty Fellowship (FIC R25TW0093), and SESH Global ( This work also receives administrative assistance from the Guangdong Provincial Center for Skin Diseases and STI Control, UNC Chapel Hill, and UNC Project-China in Guangzhou, China. The listed grant funders played no role in any step of this study.

    Publisher Copyright:
    © 2017 The Author(s).


    • China
    • Crowdsourcing
    • HIV
    • HIV testing
    • Men who have sex with men (MSM)
    • Stepped wedge randomized controlled trial


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